HomeMy WebLinkAboutAndy Pease Form 700CALIFORNIA • - 1 1 STATEMENT OF ECONOMIC INTERESA_
COVER PAGE I AUG 10 2016
Please type or print in ink.
NAME OF FILER (LAST) (FIRST) itfj—
1. Office, Agency, or Court
Agency Name (D
Division, Board, D
W
not use acronyms)
0000 c(I
lartment, District, if applicable
T1
Your Position
► If filing for multiple positions, list below or on an attachment. (Do not use acronyms) /
Agency: /� Position: 31-A —
2. Jurisdiction of Office (Check at least one box)
❑ State
❑ Multi -County ........... ...... _.._-.......
_.
[R City of Sat yt) L d i 5 0 6; 5 P Q
3. Type of Statement (Check at least one box)
❑ Annual: The period covered is January 1, 2015, through
December 31, 2015.
.or -
The period covered is through
December 31, 2015.
❑ Assuming Office: Date assumed
❑ Judge or Court Commissioner (Statewide Jurisdiction)
F-1 Cnunty of
❑ Other
❑ Leaving Office: Date Left I I
(Check one)
O The period covered is January 1, 2015, through the date of
-or-
leaving office.
O The period covered is through
the date of leaving office.
® Candidate: Election year 2016 and office sought, if different than Part 1
4. Schedule Summary (must complete) ► Total number of pages including this cover page:
Schedules attached
® Schedule A-1 - Investments — schedule attached
X Schedule A-2 - Investments — schedule attached
❑ Schedule B - Real Property — schedule attached
.or -
0 None - No reportable interests on any schedule
❑ Schedule C - Income, Loans, & Business Positions — schedule attached
❑ Schedule D - Income — Gifts — schedule attached
❑ Schedule E - Income — Gifts — Travel Payments — schedule attached
5. Verification ,
CITY STATE ZIP CODE
(Business or Agency Address Recommended - Public Document)
_.. .......... ................. _..
DAYTIME TELEPHONE NUMBER
(2015/2016)
- FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
SCHEDULE A-1 CALIFORNIA .
m 700
Investments FAIR POLITICAL PRACTICES COMMISSION
Stocks, Bonds, and Other Interests Name
(Ownership Interest is Less Than 100o) n��ea'��n� " 1edSe_
Do not attach brokerage or financial statements.
► NAME OF BUSINESS ENTITY
San_Su f aer.i Cern+e-r
GENERAL DESCRIPTION OF THIS BUST SSJ
Sorer- cen6_(- v%cl,,d�vtoPl�i�alw���
FAIR MARKET VALUE
❑ $2,000 - $10,000 $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock 0 Other Ska w^e—
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE
� / 15 / 15
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
7 $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other.
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE
� j 15 /_A_
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
� / 15 1 /1 -5 -
ACQUIRED
15ACQUIRED DISPOSED
Comments:
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other.
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
� /15 /15
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
— / 15 / 15
ACQUIRED DISPOSED
► NAME OF BUSINESS ENTITY
GENERAL DESCRIPTION OF THIS BUSINESS
FAIR MARKET VALUE
❑ $2,000 - $10,000 ❑ $10,001 - $100,000
❑ $100,001 - $1,000,000 ❑ Over $1,000,000
NATURE OF INVESTMENT
❑ Stock ❑ Other
(Describe)
❑ Partnership O Income Received of $0 - $499
O Income Received of $500 or More (Report on Schedule C)
IF APPLICABLE, LIST DATE:
� / 15 _� / 15
ACQUIRED DISPOSED
FPPC Form 700 (2015/2016) Sch. A-1
FPPC Advice Email: advice@fppc.ca.gov
FPPC Toll -Free Helpline: 866/275-3772 www.fppc.ca.gov
SCHEDULE A-2 CALIFORNIA FORM700
Investments, Income, and Assets FAIR POLITICAL PRACTICES COMMISSION
of Business Entities/Trusts Name
(Ownership Interest is 10% or Greater)
1. BUSINESS ENTITY OR TRUST 1. BUSINESS ENTITY OR TRUST
Name Name
Check one
❑ Trust, go to 2 ® Business Entity, complete the box, then go to 2
GENERAL DESCRIPTION OF THIS BUSINESS
M 4, cgl e u e r o. ire.
FAIR MARKET VALUE IF APPLICABLE, LIST DATE:
❑ $0 - $1,999
❑ $2,000 - $10,000
❑ $10,001 - $100,000 ACQUIRED DISPOSED
® $100,001 - $1,000,000
❑ Over $1,000,000
i
NATURE OF INVESTMENT
® Partnership ❑ Sale Proprietorship ❑ T�...._..._
Other
YOUR BUSINESS POSITION K.D. Pa 4y1e r
-1- 2. IDENTIFY THE GROSS INCOME RECEIVED (INCLUDE YOUR PRO RATA
SHARE OF •SS INCOME TO THE ENTITY/TRUST)
❑ $0 -$499 ❑ $10,001 - $100,000
❑ $500 - $1,000 ® OVER $100,000
❑ $1,001 - $10,000
b- 3, LIST THE NAME OF ••-TABLE SINGLE SOURCE OF
INCOMEOF r 00 OR MORE
0 None or L7 Names listed below
o. 4, INVESTMENTS ■ INTERESTS IN REAL PROPERTY■ OR
LEASED BY THE BUSINESS ENTITY OR TRUST
Check one box:
❑ INVESTMENT ❑ REAL PROPERTY
Name of Business Entity, if Investment, or
Assessor's Parcel Number or Street Address of Real Property
Description of Business Activity or
City or Other Precise Location of Real Property
FAIR MARKET VALUE
IF APPLICABLE, LIST DATE:
❑ $2,000 - $10,000
❑ $10,001 - $100,000
$100,001 - $1,000,000
ACQUIRED DISPOSED
Over $1,000,000
NATURE OFINTEREST
❑ Property Ownership/Deed of Trust
❑ Stock ❑ Partnership
❑ Leasehold ❑ Other.
Yrs remaining
❑ Check box if additional schedules reporting investments or real property
are attached
FPPC Form 700 (2015/2016) Sch. A-2
FPPC Advice Email: advice@fppc.ca.gov
FPPCToll-Free Helpline:866/275-3772 www.fppc.ca.gov